Predictors for incidence and remission of nonalcoholic fatty liver disease in obese children and adolescents

Background/Purpose: The status of nonalcoholic fatty liver disease (NAFLD) can wax and wane over time in children. However, the factors affecting its incidence and remission remain elusive. We aimed to investigate NAFLD incidence, remission and predicting factors in obese children. Methods: Obese ch...

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Main Authors: Yu-Cheng Lin, Pi-Feng Chang, Kevin Liu, Mei-Hwei Chang, Yen-Hsuan Ni
Format: Article
Language:English
Published: Elsevier 2022-01-01
Series:Journal of the Formosan Medical Association
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S0929664621000218
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author Yu-Cheng Lin
Pi-Feng Chang
Kevin Liu
Mei-Hwei Chang
Yen-Hsuan Ni
author_facet Yu-Cheng Lin
Pi-Feng Chang
Kevin Liu
Mei-Hwei Chang
Yen-Hsuan Ni
author_sort Yu-Cheng Lin
collection DOAJ
description Background/Purpose: The status of nonalcoholic fatty liver disease (NAFLD) can wax and wane over time in children. However, the factors affecting its incidence and remission remain elusive. We aimed to investigate NAFLD incidence, remission and predicting factors in obese children. Methods: Obese children aged 9–10 and 12–13 years were recruited from schools and followed up for 2 years. Liver ultrasonography was performed at baseline and Year 1. Alanine aminotransferase (ALT) concentrations were measured at baseline, Year 1 and Year 2. Elevated ALT was defined as above 26 U/L for boys and 22 U/L for girls. Four NAFLD susceptible genes, including PNPLA3, GCKR, TM6SF2 and MBOAT7, were genotyped. We analyzed the effects of these risk factors on the incidence and remission of NAFLD and elevated ALT. Results: At baseline, 86 of 440 (19.5%) subjects had ultrasonography-diagnosed NAFLD. At Year 1, of 264 subjects without NAFLD at baseline, 20 (7.6%) developed NAFLD. The baseline BMI z-score and increment in BMI z-score independently predicted incident NAFLD. Of the 68 subjects with NAFLD at baseline, 36 (52.9%) had NAFLD remission. Decrement in BMI z-score independently predicted NAFLD remission. The four studied NAFLD susceptible genes were not significantly associated with either the incidence or remission of NAFLD. In addition, changes in BMI z-score predicted the incidence and remission of elevated ALT from Year 1 to Year 2. Conclusion: Obese children with increasing BMI are more likely to develop NAFLD and those with decreasing BMI are more likely to have NAFLD remission.
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spelling doaj.art-6804b7333f3849e783c832f8114309972022-12-21T18:13:29ZengElsevierJournal of the Formosan Medical Association0929-66462022-01-0112113642Predictors for incidence and remission of nonalcoholic fatty liver disease in obese children and adolescentsYu-Cheng Lin0Pi-Feng Chang1Kevin Liu2Mei-Hwei Chang3Yen-Hsuan Ni4Department of Pediatrics, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Oriental Institute of Technology, New Taipei City, TaiwanDepartment of Pediatrics, Far Eastern Memorial Hospital, New Taipei City, TaiwanDepartment of Pediatrics, Far Eastern Memorial Hospital, New Taipei City, TaiwanDepartment of Pediatrics, National Taiwan University Hospital, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan; Corresponding author. College of Medicine, National Taiwan University, No.8, Chung Shan S. Rd., Taipei, 10002, Taiwan. Fax: +(886-2)-23114592.Background/Purpose: The status of nonalcoholic fatty liver disease (NAFLD) can wax and wane over time in children. However, the factors affecting its incidence and remission remain elusive. We aimed to investigate NAFLD incidence, remission and predicting factors in obese children. Methods: Obese children aged 9–10 and 12–13 years were recruited from schools and followed up for 2 years. Liver ultrasonography was performed at baseline and Year 1. Alanine aminotransferase (ALT) concentrations were measured at baseline, Year 1 and Year 2. Elevated ALT was defined as above 26 U/L for boys and 22 U/L for girls. Four NAFLD susceptible genes, including PNPLA3, GCKR, TM6SF2 and MBOAT7, were genotyped. We analyzed the effects of these risk factors on the incidence and remission of NAFLD and elevated ALT. Results: At baseline, 86 of 440 (19.5%) subjects had ultrasonography-diagnosed NAFLD. At Year 1, of 264 subjects without NAFLD at baseline, 20 (7.6%) developed NAFLD. The baseline BMI z-score and increment in BMI z-score independently predicted incident NAFLD. Of the 68 subjects with NAFLD at baseline, 36 (52.9%) had NAFLD remission. Decrement in BMI z-score independently predicted NAFLD remission. The four studied NAFLD susceptible genes were not significantly associated with either the incidence or remission of NAFLD. In addition, changes in BMI z-score predicted the incidence and remission of elevated ALT from Year 1 to Year 2. Conclusion: Obese children with increasing BMI are more likely to develop NAFLD and those with decreasing BMI are more likely to have NAFLD remission.http://www.sciencedirect.com/science/article/pii/S0929664621000218AminotransferaseBody mass indexNAFLDObesitySteatosis
spellingShingle Yu-Cheng Lin
Pi-Feng Chang
Kevin Liu
Mei-Hwei Chang
Yen-Hsuan Ni
Predictors for incidence and remission of nonalcoholic fatty liver disease in obese children and adolescents
Journal of the Formosan Medical Association
Aminotransferase
Body mass index
NAFLD
Obesity
Steatosis
title Predictors for incidence and remission of nonalcoholic fatty liver disease in obese children and adolescents
title_full Predictors for incidence and remission of nonalcoholic fatty liver disease in obese children and adolescents
title_fullStr Predictors for incidence and remission of nonalcoholic fatty liver disease in obese children and adolescents
title_full_unstemmed Predictors for incidence and remission of nonalcoholic fatty liver disease in obese children and adolescents
title_short Predictors for incidence and remission of nonalcoholic fatty liver disease in obese children and adolescents
title_sort predictors for incidence and remission of nonalcoholic fatty liver disease in obese children and adolescents
topic Aminotransferase
Body mass index
NAFLD
Obesity
Steatosis
url http://www.sciencedirect.com/science/article/pii/S0929664621000218
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